Issue link: https://beckershealthcare.uberflip.com/i/1544291
31 PHARMACY Why pharmacy integration is no longer optional By Ella Jeffries A s therapies become more specialized and expensive, patients are relying on pharmacy teams for more than medication dispensing. Health systems are responding by integrating pharmacists more deeply into clinical care, particularly in specialty and oncology settings, where treatment complexity and coordination demands are highest. "Patients increasingly expect pharmacists to act as clinical partners, not just dispensers," said Irvin Alfonso, PharmD, director of inpatient pharmacy at Tampa, Fla.-based Moffitt Cancer Center. At organizations expanding specialty pharmacy services, access and affordability have emerged as major pressure points. Leaders say patients often are confronted with cost uncertainty and administrative hurdles early in their care journey, making financial transparency and medication strategy central to pharmacy operations. "All these challenges will require us to provide cost visibility early and leverage biosimilar strategies to improve access and affordability," Dr. Alfonso said. Delays in therapy initiation remain a persistent concern, particularly as reimbursement complexity grows. Pharmacy leaders say preventing those delays increasingly depends on tighter workflows and more robust patient management infrastructure — even as financial pressures limit how quickly services can scale. "Specialty pharmacy growth requires greater workflow precision and a stronger patient management infrastructure to reduce financial delays that directly affect therapy start times," Dr. Alfonso said. Beyond clinical coordination, patient expectations also are being shaped by experiences outside of healthcare. As consumers grow accustomed to speed, transparency and digital convenience in other industries, those expectations are carrying over into pharmacy interactions. "Patient expectations have gained ground toward on- demand, consumer-oriented experiences with fast access, transparent communication and seamless service that mirrors what they receive from retail, banking, travel and even online investing and betting," said John Armitstead, vice president of pharmacy services at Fort Myers, Fla.- based Lee Health. Even with the push toward digital tools and streamlined access, leaders caution that efficiency alone does not define a positive pharmacy experience. "Patients still expect empathy and trust … with a human connection, clinical quality and accountability," Mr. Armitstead said. Balancing these expectations with workforce shortages and financial constraints continues to challenge health systems. Still, pharmacy leaders say the shift underway is not optional. "Challenges in meeting these expectations are certain, but the quest is an inevitable journey," Mr. Armitstead said. As pharmacy services continue to evolve, leaders say success will hinge on health systems' ability to combine clinical integration, operational efficiency and digital convenience with strategies that address affordability and access — areas where progress remains uneven across the industry. n to 4,500 cities by the end of 2026 and continues to promote its $5-per-month RxPass subscription program. CVS has embedded federal discount programs into its nationwide footprint. Walgreens went private and split into five standalone companies following multibillion-dollar operating losses, positioning itself for long-term restructuring. ese moves reflect a shi toward convenience, subscription pricing and transparent cash benchmarks as competitive differentiators. Hospital-based pharmacy, by contrast, remains largely integrated into care delivery and enterprise reimbursement systems. at alignment supports care coordination but does not inherently compete on speed or subscription economics. 5. 2027 is an operational inflection point. For health system leaders, the shi heading into 2027 is about operating in a pricing environment with clearer boundaries — and less insulation. IRA negotiation will expand. Transparency requirements will tighten. PBM compensation faces greater scrutiny. Voluntary MFN agreements may be codified through congressional action, depending on legislative outcomes. At the same time, proposed international reference pricing pilots for Medicare introduce legal and timing uncertainty that could shape implementation timelines. at combination is reshaping contracting dynamics and long- range planning. Specialty pharmacy margins, infusion services and outpatient growth strategies must now account for negotiated price ceilings, public benchmarks and evolving regulatory oversight. e question for 2027 is not whether disruption continues. It is how well pharmacy operations are aligned for a market in which pricing authority is more visible and more tightly regulated than before.n